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APHA Scientific Session and Event Listing

Recorded presentation

David M. Mosen, PhD, MPH¹, Michael Schatz, MD, MS², William M. Vollmer, PhD¹, and Elizabeth O'Connor, PhD¹. (1) Kaiser Permanente Center for Health Research, 3800 N Interstate Avenue, Portland, OR 97227-1110, 503-335-6637, david.m.mosen@kpchr.org, (2) Department of Allergy, Kaiser Permanente, 7060 Clairemont Mesa Blvd., San Diego, CA 92111

Objective: Obesity is a growing health problem in the United States and associated with increased morbidity and mortality. Obesity may also impact persistent asthmatics' ability to control their asthma. Despite these potential health effects, little is know about the impact of obesity on asthma-specific outcomes among persistent asthmatics. This study has 2 objectives: 1) determine the prevalence of obesity within the persistent asthma population and 2) determine the independent association of obesity with asthma-specific quality of life, asthma control problems and asthma-specific prior hospitalizations.

Methods: We examined survey data of 1113 persistent asthmatics enrolled in a staff model HMO. Individuals were eligible for the survey if they were at least 35 years of age and had in a two-year period preceding the survey either 1) at least one documented asthma-related encounter, or 2) at least a six months supply of asthma medication dispensed. Body Mass Index (BMI) was calculated by height and weight self-reported on the survey. Two valid and reliable tools were included: 1) Mini Asthma Quality of Life Questionnaire (AQLQ), a disease-specific quality of life questionnaire (1=lowest QOL, 7=highest QOL) and 2) the Asthma Therapy Assessment Questionnaire (ATAQ) which measures asthma control problems (0=no control problems 4=4 control problems). Respondents were also asked whether they had any asthma-specific hospitalizations in the year prior to interview.

Logistic Regression was used to examine the independent association of obesity status (BMI >= 30 vs BMI < 30) on AQLQ score (low quality of life vs. high quality of life), asthma control (>= 1 control problems vs. none), and asthma-specific hospitalizations in the past year (>= 1 vs. none) after adjusting for age, gender, race/ethnicity, educational attainment, income, reflux status, smoking status, and oral steroid use.

Results: We found that 37% of the study population had a BMI of 30 or higher, the established indicator for obesity. After adjusting for demographic factors and other patient characteristics, obesity was independently association with lower AQLQ scores (OR=2.6, 95% CI=1.6-4.4), more asthma control problems (OR=2.8, 95% CI=1.8-4.5) and more asthma-related hospitalizations (OR=4.4, 95% CI=1.8-13.7)

Conclusions: We found that obesity was independently associated with lower quality of life and an increased risk of asthma control problems and asthma-specific hospitalizations. Further research is needed to better understand the association of obesity with asthma-specific outcome measures and whether incremental weight loss for obese persistent asthmatics results in improved health outcomes.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the prevalence of obesity in the persistent asthma population.
• Articulate whether obesity is associated with poorer outcomes in the persistent asthma population.
• Identify a research plan to better understand the impact of obesity on patient outcomes among persistent asthmatics.

Keywords: Asthma, Obesity

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation